CALIFORNIA — A ballot initiative sponsored by the California Hospital Association qualified for the November 2026 ballot on June 5. The initiative would require healthcare labor unions with more than 50,000 members to inform their members annually about how dues are spent on political activities.
This initiative mandates that healthcare unions specifically report expenditures on state and local ballot measures. It also requires a majority of union members to approve political expenditures. The California secretary of state reported that 78% of the 931,534 submitted signatures for the initiative are projected to be valid.
To qualify an initiated state statute for the California ballot, petitioners must collect signatures equal to 5% of votes cast in the prior gubernatorial election. The signature threshold for an initiated state statute in California is 546,651 valid signatures.
The campaign supporting the initiative, Californians for Health Care Workers' Right to Vote, reported $11 million in contributions through April 9, 2026. All contributions to this campaign came from the California Hospitals Committee on Issues, which is sponsored by the California Association of Hospitals and Health Systems.
Three specific unions, SEIU Local 2015, the California Nurses Association, and SEIU-UHW, each have over 50,000 members, which means the initiative would apply to them if passed. Five other initiatives and three legislative referrals have qualified for the November California ballot. These qualified measures address topics including healthcare executive compensation, housing, clinic spending, tax vote requirements, voter identification, campaign finance, recall elections, and vote thresholds for ballot measures. Signature verification is also pending for nine additional ballot initiatives in California.